益气养阴散聚方治疗早期糖尿病肾病临床研究
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摘要
目的:观察益气养阴散聚方治疗早期糖尿病肾病(DKD)的临床疗效。方法:将78例早期DKD患者随机分为4组,每组患者在常规治疗基础上分别用替米沙坦片(A组,n=20)、阿托伐他汀钙片(B组,n=20)、替米沙坦片联合阿托伐他汀钙片(C组,n=19)及益气养阴散聚方(D组,n=19)进行治疗。比较4组治疗前后体质量指数(BMI)、血压[收缩压(SBP)、舒张压(DBP)]、血糖[空腹血糖(FBG)、餐后2 h血糖(P2h BG)]、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]及血清胱抑素C (CysC)水平,以及24 h尿微量白蛋白排泄率(UAER)和尿Nephrin排泄情况。结果:与治疗前比较,C组和D组的TG、CysC、24 h UAER和尿Nephrin水平均降低,差异均有统计学意义(P <0.05)。治疗后,C组和D组的TC、TG、LDL-C、CysC和尿Nephrin水平均低于A组,差异均有统计学意义(P <0.05);C组和D组24 h UAER和尿Nephrin水平均低于B组,差异均有统计学意义(P <0.05)。结论:益气养阴散聚方治疗早期DKD临床疗效显著,可有效改善患者的肾功能,调节血脂及尿微量白蛋白(MAU),延缓DKD进展。
Objective: To observe the clinical effect of Yiqi Yangyin Sanju prescription for early diabetic kidney disease(DKD).Methods: Divided 78 cases of patients with early DKD into four groups randomly, and each group respectively was treated with telmisartan tablets(Group A,n=20),atorvastatin tablets(Group B,n=20),telmisartan tablets combined with atorvastatin tablets(Group C,n=19),and Yiqi Yangyin Sanju prescription(Group D,n=19) based on the routine treatment. Compared body mass index(BMI),levels of blood pressure including systolic blood pressure(SBP) and diastolic blood pressure(DBP),blood glucose including fasting blood glucose(FBG) and postprandial 2 h blood glucose(P2 hBG),blood lipid including total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) and serum cystatin C(CysC),compared 24 h urinary albumin excretion rate(UAER) and urinary Nephrin excretion in the four groups before and after treatment. Results: Compared with those before treatment, levels of TG, CysC, 24 h UAER and urinary Nephrin in Group C and Group D were decreased,differences being significant(P < 0.05). After treatment,levels of TC, TG, LDL-C, CysC and urinary Nephrin in Group C and Group D were lower than those in Group A, differences being significant(P < 0.05). Levels of 24 h UAER and urinary Nephrin in Group C and Group D were lower than those in Group B,differences being significant(P < 0.05). Conclusion: The therapy of Yiqi Yangyin Sanju prescription for early DKD has significant clinical effect,which can effectively improve the kidney function of patients,regulate blood lipid and microalbunminuria(MAU),and delay the development of DKD.
Objective: To observe the clinical effect of Yiqi Yangyin Sanju prescription for early diabetic kidney disease(DKD).Methods: Divided 78 cases of patients with early DKD into four groups randomly, and each group respectively was treated with telmisartan tablets(Group A,n=20),atorvastatin tablets(Group B,n=20),telmisartan tablets combined with atorvastatin tablets(Group C,n=19),and Yiqi Yangyin Sanju prescription(Group D,n=19) based on the routine treatment. Compared body mass index(BMI),levels of blood pressure including systolic blood pressure(SBP) and diastolic blood pressure(DBP),blood glucose including fasting blood glucose(FBG) and postprandial 2 h blood glucose(P2 hBG),blood lipid including total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) and serum cystatin C(CysC),compared 24 h urinary albumin excretion rate(UAER) and urinary Nephrin excretion in the four groups before and after treatment. Results: Compared with those before treatment, levels of TG, CysC, 24 h UAER and urinary Nephrin in Group C and Group D were decreased,differences being significant(P < 0.05). After treatment,levels of TC, TG, LDL-C, CysC and urinary Nephrin in Group C and Group D were lower than those in Group A, differences being significant(P < 0.05). Levels of 24 h UAER and urinary Nephrin in Group C and Group D were lower than those in Group B,differences being significant(P < 0.05). Conclusion: The therapy of Yiqi Yangyin Sanju prescription for early DKD has significant clinical effect,which can effectively improve the kidney function of patients,regulate blood lipid and microalbunminuria(MAU),and delay the development of DKD.
引文
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[7]张曼玲,张莹雯.从糖尿病肾病病机论中医药对糖尿病肾病治疗的研究进展[J].天津中医药,2017,34(9):640-644.
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[9]袁旻健,章伟,汪天湛,等.益气化浊颗粒治疗早期糖尿病肾病微量白蛋白尿临床研究[J].上海中医药杂志,2013,47(5):37-39.
[10]陈腾,简桂花,汪年松.黄芪治疗糖尿病肾病的研究进展[J].中国中西医结合肾病杂志,2017,18(5):462-464.
[11]Ni WJ,Ding HH,Tang LQ.Berberine as a promising anti-diabetic nephropathy drug:an analysis of its effects and mechanisms[J].Eur J Pharmacol,2015,760:103-112.
[12]Wei S,Zhang M,Yu Y,et al.Berberine attenuates development of the hepatic gluconeogenesis and lipid metabolism disorder in type 2 diabetic mice and in palmitate-incubated HepG2 cells through suppression of the HNF-4αmi R122pathway[J].PLo S One,2016,11(3):e0152097.
[2]臧赢君,王利,曹爱丽,等.糖尿病肾病足细胞损伤机制及中药干预研究进展[J].天津中医药,2017,34(11):785-788.
[3]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:233-234.
[4]Li X,Chuang PY,D'Aqati VD,et al.Nephrin Preserves Podocyte Viability and Glomerular Structure and Function in Adult Kidneys[J].J Am Soc Nephrol,2015,26(10):2361-2377.
[5]李红微,刘胜阳,刘云霞,等.替米沙坦片治疗早期糖尿病肾病的效果观察[J].中国当代医药,2016,23(4):73-75.
[6]张瑶,汪力,高芳,等.阿托伐他汀对糖尿病肾病微炎症状态的影响[J].西部医学,2016,28(2):215-217,220.
[7]张曼玲,张莹雯.从糖尿病肾病病机论中医药对糖尿病肾病治疗的研究进展[J].天津中医药,2017,34(9):640-644.
[8]齐铮,赵进喜,王硕仁,等.糖尿病肾病中医证候分布规律的文献研究[J].环球中医药,2012,5(12):914-917.
[9]袁旻健,章伟,汪天湛,等.益气化浊颗粒治疗早期糖尿病肾病微量白蛋白尿临床研究[J].上海中医药杂志,2013,47(5):37-39.
[10]陈腾,简桂花,汪年松.黄芪治疗糖尿病肾病的研究进展[J].中国中西医结合肾病杂志,2017,18(5):462-464.
[11]Ni WJ,Ding HH,Tang LQ.Berberine as a promising anti-diabetic nephropathy drug:an analysis of its effects and mechanisms[J].Eur J Pharmacol,2015,760:103-112.
[12]Wei S,Zhang M,Yu Y,et al.Berberine attenuates development of the hepatic gluconeogenesis and lipid metabolism disorder in type 2 diabetic mice and in palmitate-incubated HepG2 cells through suppression of the HNF-4αmi R122pathway[J].PLo S One,2016,11(3):e0152097.